Family Psychiatric History Linked to Bipolar Disorder Severity


It’s no surprise that our family can have an impact on how we grow up: our behaviors, beliefs, attitudes, values. But perhaps most importantly, our family history impacts our health. In an international study, researchers wanted to understand how family psychiatric history impacted the progression and severity of bipolar disorder. Ultimately, they found that there was a correlation. Check out the full study in Journal of Affective Disorders.

Bipolar Disorder

Bipolar disorder can be considered a mood disorder, or a disorder characterized by emotional inconsistency that gets in the way of daily function. According to the National Alliance on Mental Illness (NAMI), bipolar disorder presents in two distinct moods: mania (high moods) and depression (low moods). Doctors aren’t sure of the exact cause, but believe it could relate to stress, brain structure, and genetics.

There are 4 types of bipolar disorder: Bipolar I, Bipolar II, cyclothymia, and unspecified. Typically, the disorder onset occurs in late teens to early 20s. The severity varies based on type, as some may experience longer periods without symptoms and others may experience rapid cycling between moods. Symptoms also vary in manic and depressive episodes.

Mania or Hypomania

To receive a bipolar disorder diagnosis, people must have experienced one manic or hypomanic episode. In some cases, mania results in psychosis. For a manic episode to occur, patients must experience at least 3 of the following:

  • Heightened activity levels, energy, or agitation
  • Racing thoughts
  • Extreme talkativeness
  • Becoming easily distracted
  • Euphoria (feeling unstoppable, overly self-confident)
  • Poor sleep
  • Feeling abnormally upbeat or awake
  • Lack of decision-making or excessive risk taking
    • Examples: spending too much money, engaging in risky sexual encounters

In some cases, people in a manic state may not recognize their mania or the impact of their actions. Because of their impulsivity, suicide is an increased risk.


Alternately, people with bipolar disorder may experience severe depressive episodes that prevent them from engaging in daily activities. To diagnose a depressive episode, patients must show 5 of the following symptoms:

  • Fatigue and energy loss
  • Suicidal thoughts
  • Indecisiveness
  • Inability to concentrate
  • Loss of interest in activities or friendships
  • Insomnia or too much sleeping
  • Restlessness or slowed movement
  • Feelings of guilt, inadequacy, and worthlessness
  • Significant weight gain or weight loss
  • Irritability
  • Feeling sad and hopeless

Learn more about bipolar disorder here.

The Study

In the study, researchers wanted to examine the correlation between family psychiatric history and bipolar disorder severity. To collect data, they examined 2 trials that lasted for 24 weeks:

  • Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness)
    • This trial compared the efficacy of lithium to quetiapine.
  • LiTMUS
    • This trial compared the efficacy of lithium treatment to treatments without lithium.

Next, researchers analyzed the data. Out of 757 total patients, 85.1% (644 patients) stated that they had at least one first-degree relative with a severe mental disorder such as bipolar disorder, depression, or alcohol abuse. They discovered that:

  • Those with a family history of mental illness were more likely to experience early symptoms, be hospitalized, or attempt suicide. Additionally, they were more likely to have less education and a lower income. These patients also required more treatment to reduce symptoms.
  • There was no correlation between family history and physical health (such as cholesterol levels, weight, etc).

Prior Data

However, their findings suggest that families who engage in mental health counseling and therapy are able to delay the onset of bipolar disease, symptoms, and other mental health challenges in high-risk patients. This is correlated by earlier data from a separate study on 127 adolescent patients, which found that family-focused therapy reduced bipolar symptoms compared to educational therapy:

  • Family-focused therapy: 12 1-hour sessions over a 4-month period consisting of teaching families to communicate and problem-solve. Additionally, this therapy included psychoeducation. 80% of patients improved their initial bipolar symptoms during the 4-weeks, with 77% maintaining that by 24 weeks.
  • Education-based therapy: 3 1-hour sessions of family psychoeducation per week for 4 months, followed by 3 youth-only sessions monthly to create a mood management plan. 65% of patients improved symptoms during the first 4 weeks, with 65.2% doing so by week 23.

Read the source article here.

Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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